Teaching and assessing clinical ethics through group reading experience and student-led discussion

Ethical decision-making is one of the foundational elements of responsible patient care, yet traditional didactic coursework often misses the nuances of specific situational aspects of ethics as well as the impact of individual patient experiences on their perspective related to health care. The purpose of this study was to assess the impact of a clinical research ethics elective course involving a group reading experience and facilitated discussion on student decision-making and perspective on questions related to ethics.

The elective was offered to second-year pharmacy students and was designed to teach ethical concepts within the framework of a group reading experience employing active learning through facilitated student-led group discussion. The book chosen was The Immortal Life of Henrietta Lacks by Rebecca Skloot. Students were assessed pre- and post-course using ethical scenarios (framed as "yes/no" questions) covering a wide range of topics, as well as over their familiarity with and confidence in making decisions related to ethical topics using a five-point Likert scale.

Sixteen students were enrolled in the course, with 14 (87.5%) completing all pre- and post-course assessments. There were no statistically significant changes in the proportion of students answering "yes" or "no" to the scenarios from pre- to post-course, though there were several items in which responses "shifted," meaning students switched answers from pre- to post-course. Overall, students showed significantly more familiarity with the topics covered after the course versus before (p < 0.05), also reporting improved confidence (p < 0.05) in making decisions related to the topics. The per-student analysis also showed significant changes in overall confidence and familiarity (p < 0.05).

Through the course, students showed increased familiarity with the history of clinical research and ethical topics discussed as well as improved confidence in making decisions related to clinical ethics. This type of course design provided a strong environment for discussion and group learning.